Latent Profile Analysis Of Workplace Bullying In Nurses And Its Relationship With Caring Behavior And Missed Nursing Care

ObjectiveThis study aims to explore the latent classes of workplace bullying in nurses,and analyze the correlation between the latent classes of workplace bullying and caring behavior and missed nursing care.To provide a theoretical basis for the later stage of workplace bullying and individualized intervention,in order to stimulate nurses’ caring behavior,reduce the missed nursing care,and improve the quality of nursing.MethodsThis study was a cross-sectional study.The convenient sampling method was used to select nurses from four Grade-A tertiary hospital in Jinan,Shandong Province as the research objects,and data were collected from July 2022 to December 2022.The survey tools included the self-designed general information questionnaire(including gender,age,marital status,number of children,education background,monthly income,employment style,working years,technical title,whether specialist nurses,frequency of night shifts per month,frequency of overtime work per month,etc.),Negative Behavior Questionnaire-Revised,Caring Behaviors Inventory,and MISSCARE survey part A.Latent profile analysis was performed using Mplus 8.0 to identify potential categories of workplace bullying suffered by nurses.SPSS 26.0 was used for further descriptive analysis,one-way analysis of variance,multi-class linear regression analysis,binary Logistic regression analysis,etc.Results(1)The score of workplace bullying was(32.20±12.27),and the score of negative personal behaviors was(12.82±4.96).The score of work-related negative behavior was(12.90±5.29).The score of organizational injustice was(6.48±2.73).(2)According to the results of latent profile analysis,the workplace bullying of nurses was divided into three latent classes: No Workplace Bullying Group,385 nurses,accounting for 70%;Severe Workplace Bullying,47 nurses,accounting for 8.55%;There were 117 nurses in Organizational Injustice Group,accounting for 21.45%.(3)The results of one-way analysis of variance showed that the potential categories of workplace bullying had statistically significant differences in the total score of workplace bullying and the scores of each dimension(P<0.001).The post-hoc comparison results showed that No Workplace Bullying Group(C1)had a significantly lower score than Organizational Injustice Group(C3)and Severe Workplace Bullying Group(C2),and Organizational Injustice Group(C3)had a significantly higher score than No Workplace Bullying Group(C1).However,it was significantly lower than the group experiencing Severe Workplace Bullying Group(C2).(4)There were significant differences in the potential categories of workplace bullying among nurses in age,monthly income,working years,technical titles,whether specialist nurses,frequency of night shifts and frequency of overtime work per month(P<0.05).(5)The total score of nurses’ caring behavior was(122.27±21.03),the score of support and guarantee was(42.08 ±7.35),the score of knowledge and skills was(26.05±4.57),the score of respect for patients was(29.83±5.67),and the score of contacting patients was(24.32±4.87).(6)The results of one-way analysis of variance showed that there were statistically significant differences in the total score of caring behavior,support and assurance score,knowledge and skills score,respect for patients score and contact with patients score in the potential categories of workplace bullying(P< 0.001).Post hoc analysis showed that No Workplace Bullying Group had significantly higher scores in caring behavior,support and assurance,knowledge and skills,respect for patients,and contact with patients than the two groups.(7)The results of general linear regression analysis of potential categories of workplace bullying and caring behavior of nurses showed that after controlling for age,monthly income,working years,technical title,whether they were specialist nurses,frequency of night shifts per month,frequency of overtime work,and other related factors,the results of linear regression analysis showed that compared with No Workplace Bullying Group(C1)nurses,Severe Workplace Bullying Group(C2)(B=-15.207,P<0.001),Organizational Injustice Group(C3)(B=-14.285,P<0.001)was still significantly lower than that of No Workplace Bullying Group(C1).(8)84.55% of the nurses reported that they missed at least one nursing activity during work.The five most frequently missed nursing activities were timely changing bed units for patients(61.27%),providing emotional support(psychological nursing)for patients and/or their families(55.64%),assisting patients to turn over every two hours(53.82%),health education about related diseases,examination,medication and other knowledge(53.82%),and focusing on patients’ conditions reassessment,making or updating the care plan(53.82%).(9)The results of χ2 test showed that the distribution of nurses with different potential categories of workplace bullying in 24 nursing activities was statistically significant.In terms of missing nursing activities,the incidences of Severe Workplace Bullying Group(C2)and Organizational Injustice Group(C3)were significantly higher than those of No Workplace Bullying Group(C1).In terms of "helping patients turn over every 2 hours" and "dietary guidance for patients",Severe Workplace Bullying Group(C2)was significantly higher than Organizational Injustice Group(C3)(P< 0.001).(10)The results of binary Logistic regression analysis showed that compared with the No Workplace Bullying Group(C1),the possibility of "no miss" was reduced by 57.5%(OR=0.425,95%CI=0.205-0.882)among Severe Workplace Bullying Group(C2).Conclusion(1)There was group heterogeneity of workplace bullying among nurses,which could be divided into three potential categories: No Workplace Bullying Group,Severe Workplace Bullying Group and Organizational Injustice Group.(2)Nurses’ age,monthly income,working years,technical title,whether they are specialist nurses,frequency of night shifts per month,frequency of overtime work per month and other factors are different among the potential categories of workplace bullying,which can predict the belonging of the latent classes.(3)Compared with No Workplace Bullying Group,the nurses in Severe Workplace Bullying Group and Organizational Injustice Group showed significantly less caring behaviors than the nurses in No Workplace Bullying Group.(4)Compared with nurses in No Workplace Bullying Group,the nurses in Severe Workplace Bullying Group and Organizational Injustice Group were more likely to miss care.Compared with nurses in the No workplace bullying group,nurses in the Severe workplace bullying group were less likely to "not miss".